Smoke gets in your eyes

Smoking is a no-brainer, right? Everyone knows it's a bad thing – it's just a matter of education and will power. Not quite. Dinyar Godrej examines the dark side of a deadly industry determined to stay alive.

It began with hurriedly scribbled notes on scraps of paper, shoved into his shoe and smuggled out. The documents Merrell Williams was reading both intrigued and infuriated him – and he knew the information was potentially explosive. Then he got bolder. Biting back fear, he stuffed documents down the front of his trousers, expecting an alarm to ring at any minute as he passed the company gates.

In 1988 Williams had been hired to code secret documents for the Brown & Williamson tobacco company in Louisville, Kentucky. He was one of a select group of coders who assessed the most sensitive documents for potential damage if revealed during a court case.

Merrell Williams was tobacco’s first whistle-blower. But what sparked his campaign against Big Tobacco? There was certainly a sense of moral outrage – he had discovered that Brown & Williamson knew by the early 1960s that nicotine was addictive – while continually denying this in public. He was sickened to discover evidence of marketing aimed at children, of product placement in movies and of industry lawyers slamming the brakes on any in-house health research that showed negative results. He thought of his father who had lit up while waiting for an ambulance to arrive after a heart attack. A year after he’d smuggled out his first incriminating document he quit his own cigarette habit.

‘...with a general lengthening of the expectation of life we really need something for people to die of?’

Report for Tobacco Advisory Council, 1978

When Williams looked for supporters he found likely allies, including journalists, were reluctant to back him because of the illegality of his methods. Changing tack, in 1993 he hired a lawyer to pursue a personal-injury claim for the damage done by his own cigarette habit and the way B&W had made him a ‘co-conspirator’ in the deceptions of the tobacco companies through his secretive coding job. He offered to return the documents in exchange for a settlement.

B&W’s lawyers threw the book at him and he found himself at the receiving end of a restraining order which barred him from discussing with anyone, including his own lawyer, any information he had learned from his work.

Eventually, a year later, the contents of William’s three boxes were leaked with the help of another lawyer. Williams never won his case against B&W but at last the genie was out of the bottle.1 (Brown & Williamson now calls itself ‘A responsible company in a controversial industry’.)

Today, in the wake of Merrell Williams, legal action has brought to the public record 400 million pages of tobacco company documents. The evidence reveals a global conspiracy to deny the lethal effects of smoking, its addictiveness and the companies’ underhand methods of promoting it. How many million more pages have been buried or gone through the shredder is anyone’s guess.

Misgivings about tobacco’s effects on health are probably as ancient as use of the weed itself – some early observers believed it dried out your innards. The Dutch made the link to impotence; and the 17th-century Chinese philosopher Fang Yizhi referred to smoking as ‘scorching one’s lungs’. By the 19th century some medical research was linking cancers of the nose and mouth with snuff and chewing tobacco.

Cancer or Zephyr?

But it was in 1950 that British epidemiologist Richard Doll established the first causative link between smoking and lung cancer. Doll, now 92, chuckles down the telephone as he recalls the sceptical response his findings received at the time. ‘

Most people in the cancer field were unaccustomed to the use of epidemiological methods to demonstrate the causes of cancer. They really relied on animal experiments; some had been carried out and had failed to produce cancer from tobacco tar. So they started from the position that this is very unlikely to be causal.’

Doll claims the British tobacco industry initially was unaware it was selling a dangerous product and behaved ‘fairly responsibly’. Later, they naturally tried to disprove it, but failing that ‘took care every time to persuade the media always to publish a report throwing doubts on the results whenever there was any reference to them. Subsequently they denied causation when their own experts advised them that smoking does cause these diseases.’

By 1957 British American Tobacco (BAT) had taken to giving cancer the code name ‘Zephyr’ in an attempt to disguise what it knew. In the US early connections between cancer and smoking saw cigarette sales plunge. The major tobacco companies responded by forming the Tobacco Industry Research Committee whose purpose was to attack scientific research linking tobacco and cancer and to engage in a pro-cigarette PR campaign.

Big Tobacco has continued to use the same tactics ever since: dismissing scientific proof, challenging health warnings, lobbying furiously against attempts to curb smoking in public places. Some of the lies and denials have been downright brazen. The ex-Philip Morris CEO Joseph F Cullman, for example, commented on a study that smoking mothers gave birth to smaller babies by saying: ‘Some women would prefer having smaller babies.’

Senior executives of seven tobacco companies raised their right hands and swore in front of a US congressional subcommittee as late as 1994 that they did not believe nicotine was addictive. This was despite research going back at least 30 years that it was as addictive as many a ‘Class A’ drug; it is certainly deadlier than heroin or cocaine in the same concentrations. A nicotine-tipped dart will fell an elephant.2 A single cigarette delivers just one milligram of nicotine, but you’d need to reduce that dose by 95 per cent to make it non-addictive. Of course doing that would remove the main reason people continue inhaling smelly smoke.

Not that this is a new passion. Tobacco cultivation is believed to have begun in South America around 6000 BC. By the first century BC indigenous people along the Andes were sniffing, chewing and ingesting it; as well as painting it on their bodies, using it for eye drops and enemas, and of course smoking it.3 The rage for tobacco went truly global after Columbus brought the first plant back to Europe.

‘Smoking behaviour of women differs from that of men... they find it harder to stop... women are more neurotic than men... there may be a case for launching a female oriented cigarette with relatively high deliveries of nicotine...’

1976 research report, British American Tobacco

By the mid-16th century it was considered something of a cure-all. ‘Medical books espoused the curative powers of tobacco for everything from flatulence to rabies, as an antiseptic and as a cure for headaches. Pity the poor asthmatics of the time – doctors recommended tobacco smoke as a cure… A bad memory? Physicians suggested tobacco smoke because it “rose to the brain, the seat of recollection”. The plague? Smoking, the medical establishment believed, would keep it at bay, prompting widespread smoking during the Great Plague of 1665. During the plague years, boys at England’s Eton College were whipped if they tried to skip their daily smoke.’2

All too soon this must-have commodity became a main player in the tragic narrative of colonialism and slavery. Tobacco was one of the first imperial crops. Slaves from Africa destined to toil on tobacco plantations in the United States were often purchased and sold with tobacco. Rather than King Cotton, it was Big Tobacco that built America.

Toxic cash

Recently the traditional head of western Uganda’s Bunyoro Kingdom announced his intention to sue Britain for £2.8 billion ($5.08 billion) at the International Court of Justice for ‘acts of pillage, rape and murder’ in the 1890s. King Solomon Iguru angrily declared: ‘British colonial elements made the population that formerly grew food crops for their families and raised livestock for animal protein into growers of a toxic and poisonous substance called tobacco. Today, my subjects are starving and malnourished growers of tobacco, a crop that poisons its growers, the people who handle it and all who consume it. There have been criminal British beneficiaries since 1927 to the present day and all along the British Crown has been aware of this. My subjects deserve a better livelihood than being producers of poison.’4

Ripped jeans beneath the chador and aspirational cigarette in hand in Iran. Smoking among young women in the West is on the up, too.
Caroline Penn / [Panos] (http://www.panos.co.uk/)

Naturally the Ugandan arm of British American Tobacco has a somewhat different perspective: ‘…about 850,000 adults countrywide derive pleasure from cigarettes and are aware of the risk posed by smoking. Over 60,000 farmers depend on tobacco as their only source of income while the industry is supporting about two million jobs.’5

This argument is often dredged up by those who defend the economics of tobacco. But any contribution tobacco might make to the economy today is purely negative. The World Bank estimates that when health costs are taken into account the global tobacco market runs at an annual loss of $200 billion. Only two countries are dependent on tobacco production – Malawi and Zimbabwe – and they must wish they weren’t. Both face a food-crops deficit and massive deforestation as hectares of trees go under the axe to cure tobacco. In many countries farmers feel caught in the tobacco trap due to their relationship with the tobacco transnationals (explored in Joe Asila’s article). They would welcome help towards switching to another crop. Consumers worldwide, many of them poor people who can’t afford it, spend more than $400 billion every year to satisfy their tobacco habit. It doesn’t take a genius to figure out that any reduction in tobacco consumption would free up funds for more useful purchases.

And yet it is incredible how the argument over jobs and economic contribution holds sway in the rarefied realms of policy-making. The European Union has finally embarked on the path to ending subsidies to tobacco growers. The crop accounts for only 0.1 per cent of farmed land in Europe yet is currently rewarded with an annual handout of $1.2 billion. Tobacco farmers get 20 times the subsidy per hectare received by those who grow food.6

In India, to cosy up to the massive electorate of the poor, the Government has subsidized the rolled-leaf smokes called bidis – even though hand-rolling them is believed to involve six million children under the age of 14.7 It has also been unsuccessful in curbing the spread of toothpaste with tobacco in it, giving children an early taste.

The Marlboro cowboy rides out of the West and into Shanghai, China.
Ron Giling / Lineair / [Still Pictures] (http://www.stillpictures.com/index.htm)

Lethal double standards have helped the tobacco transnationals push into the Majority World. Hemmed in by restrictions on advertising and declining smoking rates in the West, they began looking hungrily towards Asia, in particular, with its huge numbers of smokers. Many Asian countries were supplied by complacent state-tobacco monopolies which produced low-quality harsh cigarettes for a captive market. But in the mid-1980s the US launched an offensive on behalf of its own tobacco companies, with Philip Morris in the lead. Country after country was threatened with sanctions if markets weren’t opened up to US tobacco. Milder and easier to smoke, foreign brands flooded the market, backed by glitzy advertising. Smoking rates began to shoot up. US Surgeon General C Everett Koop voiced his displeasure at the time: ‘I don’t think we as citizens can continue exporting disease, disability and death.’

The greatest prize is China, where the social acceptability of smoking is high and over 60 per cent of men smoke. ‘Thinking about Chinese smoking statistics is like trying to think about the limits of space,’ drools a Rothmans document from 1992.7 Currently the Chinese state tobacco monopoly is the world’s largest cigarette producer. The country gets about ten per cent of its tax income from smokers – though that amounts to just over half the billions it loses in productivity and healthcare costs according to the World Health Organization.8 The tobacco giants have been making inroads into the Chinese market by allowing their cigarettes to be smuggled wholesale into the country and, more recently, by buying into the Chinese monopoly. A US-China bilateral agreement slashed tariffs on imported cigarettes this year. The Marlboro cowboy rides in China, while he’s been unsaddled in the West. There are even plans on the drawing board to develop special cigarettes for Chinese women, who are traditionally more reticent about smoking.

‘...reflecting 5.23 years of life lost for the average smoker – indirect positive effects [are that] public finance benefits from smoking indirectly, via savings on the healthcare costs – in pensions – and public housing costs savings.’

Anti-tobacco activists around the world are backing a WHO-initiated Convention (read more about it in Battling the BATmen) that could put the clamps on tobacco promotion and stop industry interference in healthcare policymaking. Alongside this they will need to encourage governments to enforce progressive taxation of tobacco products – as smokers feel the pinch, many manage to give up. Bans on workplace smoking and smoking in public, besides creating an aura of social unacceptability, also lead to smokers quitting. The ban on smoking in Irish pubs earlier this year has been a resounding success, with no instances of ‘smoke rage’ and no falloff in customers. The only significant change has been in drinks left unattended – as smokers dash out for a quick puff. The hard slog of constant public education with clinical support for quitters will also need to continue.

The tobacco industry in the West feels beleaguered and the damage to their image is irreversible. Martin Broughton, the outgoing Chair of British American Tobacco, lashed out against the restrictions on his industry during the BAT annual meeting in April. ‘Some health policymakers show signs of having been “captured” by narrowly based, vociferous anti-tobacco activists, who are sometimes even funded by the regulators they are lobbying? An example is the growing use of “graphic image” health warnings, which threaten our intellectual property rights [!] and can harass consumers.’9 One’s heart bleeds.

It is estimated that a hundred million people died as a result of their tobacco habit during the 20th century. Without effective controls this number could rise to a billion by the end of this century. In 25 years tobacco is expected to be the single largest cause of death.10

So why not just ban the weed? If cigarettes were being introduced today, they would never pass consumer safety tests. The answer lies in the historically and culturally embedded nature of tobacco use. While many European countries moved swiftly to ban attempts to introduce chewing tobacco, smoking is more difficult – it already exists and is well established.

Then there is the compelling argument that individuals should be free to make their own choices, even if they are risky ones. Any democratically minded person would find it difficult to disagree. But any ‘right to smoke’ should be accompanied by an absence of image manipulation through advertising, film stars and the media; by a knowledge that there is a nine in ten chance of becoming addicted; by the smoker’s active awareness of the health effects and consent to their own likely slow suicide; by an undertaking not to endanger the health of others around them; by true freedom of choice, which includes being able to choose when to quit, not the compulsion of the addict hankering for the next fix.

Looking good

Philip Morris, the number one tobacco transnational, is part of the huge Altria empire, which includes Kraft foods and Miller beer. Unable to advertise cigarettes in the US, Altria (the name has an oddly altruistic ring) demonstrates its social conscience instead by taking out public awareness advertisements about domestic violence and women. When cigarette advertising was still permitted, Philip Morris planned changing the image of their Marlboro cowboy for the ‘caring’ 90s.

New Myth: Cowboys are sensitive. Cowboys are advocates of the land. Cowboys are Indians. Women are cowboys. Cowboys ride the range with their wives. Cowboys have principles. Cowboys are kind. Cowboys eat grilled vegetable fajitas. Cowboys dance with wolves.

For a fuller account see Assuming the Risk: The Mavericks, the Lawyers and the Whistle-Blowers Who Beat Big Tobacco by Michael Orey, Little, Brown and Company, Boston, 1999. The documents Merrell Williams liberated can be viewed at http://www.library.ucsf.edu/tobacco/

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